GlobalChild Platform

1. States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.
2. States Parties shall pursue full implementation of this right and, in particular, shall take appropriate measures:

(a)   To diminish infant and child mortality;

(b)  To ensure the provision of necessary medical assistance and health care to all children with emphasis on the development of primary health care;

(c)   To combat disease and malnutrition, including within the framework of primary health care, through, inter alia, the application of readily available technology and through the provision of adequate nutritious foods and clean drinking-water, taking into consideration the dangers and risks of environmental pollution;

(d)  To ensure appropriate pre-natal and post-natal health care for mothers;

(e)  To ensure that all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, the advantages of breastfeeding, hygiene and environmental sanitation and the prevention of accidents;

(f)   To develop preventive health care, guidance for parents and family planning education and services.

3.     States Parties shall take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children.

4. States Parties undertake to promote and encourage international co-operation with a view to achieving progressively the full realization of the right recognized in the present article. In this regard, particular account shall be taken of the needs of developing countries.

-UN Convention on the Rights of the Child

The core attributes of Article 24 are:

• A right to the enjoyment of the highest attainable standard of health
• A right to the basic minimum standards of child health
• Child health accountability mechanisms
• International cooperation for child health in developing countries

Each of these attributes can be measured in terms of structural or process implementation or in terms of outcomes achieved through implementation as outlined in the table below. Some indicators, for instance the structural ones, may be common to all attributes. Others are common to two or more attributes, while some indicators may be relevant to one attribute only. An attempt has been made to balance the use of objective and subjective data indicators as well as qualitative and quantitative ones.

These are some ideas that children from around the world shared with us during the Global Child Rights Dialogue (GCRD) project:

1. Goal 1 End poverty in all its forms everywhere
   • Target 1.4 By 2030, ensure that all men and women, in particular the poor and the vulnerable, have equal rights to economic resources, as well as access to basic services, ownership and control over land and other forms of property, inheritance, natural resources, appropriate new technology and financial services, including microfinance.
2. Goal 2 End hunger, achieve food security and improved nutrition and promote sustainable agriculture
   • Target 2.1 By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round.
   • Target 2. 2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons.
3. Goal 3 Ensure healthy lives and promote well-being for all at all ages
   • Target 3.a Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate.
   • Target 3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.
   • Target 3.c Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States.
   • Target 3.d Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.
   • Target 3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
   • Target 3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.
   • Target 3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
   • Target 3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • Target 3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents.
   • Target 3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
   • Target 3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
   • Target 3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.
4. Goal 5 Achieve gender equality and empower all women and girls
   • Target 5.3 Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation.
   • Target 5.6 Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
5. Goal 6 Ensure availability and sustainable management of water and sanitation for all
   • Target 6.a By 2030, expand international cooperation and capacity-building support to developing countries in water- and sanitation-related activities and programmes, including water harvesting, desalination, water efficiency, wastewater treatment, recycling and reuse technologies.
   • Target 6.1 By 2030, achieve universal and equitable access to safe and affordable drinking water for all.
   • Target 6.2 By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations.
   • Target 6.3 By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing release of hazardous chemicals and materials, halving the proportion of untreated wastewater and substantially increasing recycling and safe reuse globally.
6. Goal 11 Make cities and human settlements inclusive, safe, resilient and sustainable
   • Target 11.2 By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons.
   • Target 11.6 By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality and municipal and other waste management.
   • Target 11.7 By 2030, provide universal access to safe, inclusive and accessible, green and public spaces, in particular for women and children, older persons and persons with disabilities.
7. Goal 12 Ensure sustainable consumption and protection patterns
   • Target 12.3 By 2030, halve per capita global food waste at the retail and consumer levels and reduce food losses along production and supply chains, including post-harvest losses.
   • Target 12.4 By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle, in accordance with agreed international frameworks, and significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment.

• Developing Indicators for the protection, respect and promotion of the rights of the child in the European Union, FRA
• Government departments, universities and other training institutions
• National data sets on child psychiatric services and mental health and addictions treatments and facilities
• National data sets on infant and child and youth health
• Primary research by National Human Rights Institutions for Children
• Qualitative research with children on their knowledge of and experience in the exercise of their rights
• Surveys of parents on knowledge of their responsibilities as parents and the right of the child
• UNICEF MICS data

1. Kilkelly, U. (2015). Health and Children’s Rights. In  W. Vanderhole, E. Desmet, D. Reynaert & S. Lembrechts (Eds.), Routledge International Handbook of Children’s Rights Studies (1st ed.,pp. 216-233). Abingdon, United Kingdom and New York, United States of America: Routledge.
2. United Nations Committee on the Rights of the Child. (2013). General comment No.15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health (Art. 24). (CRC/C/GC/15), (para. 5, 38, 39 and 109). Retrieved from the United Nations High Commissioner of Human Rights website: https://www.refworld.org/docid/51ef9e134.html
3. World Health Organization. (2017). Leading the realization of human rights to health and through health: Report of the High-Level Working Group on the Health and Human Rights of Women, Children and Adolescents (ISBN 978-92-4-151245-9). Geneva, Switzerland: World Health Organization. Retrieved from https://apps.who.int/iris/handle/10665/255540
4. United Nations Children’s Fund (UNICEF). (n.d.). Mapping the Global Goals for Sustainable Development and the Convention on the Rights of the Child. Retrieved from https://www.unicef.org/media/60231/file

• Annie E. Casey Foundation. (2017). 2017 Kids Count Data Book. State trends in child well-being. Baltimore, United States of America: The Annie E. Casey Foundation.
• Office of Disease Prevention and Health Promotion. (2019). Healthy People 2020. Retrieved from https://www.healthypeople.gov
• United Nations General Assembly. (2015). Sustainable Development Goals. Retrieved from https://sustainabledevelopment.un.org/?menu=1300
• UNICEF. (2007). Implementation handbook for the Convention on the Rights of the Child (Fully rev. 3rd ed., pp.186). Geneva, Switzerland: UNICEF
• United Nations Office of High Commissioner of Human Rights (OHCHR) (2012). Human Rights Indicators: A Guide to Measurement and Implementation (HR/PUB/12/5). Retrieved from http://www.ohchr.org/Documents/Publications/Human_rights_indicators_en.pdf
• World Health Organization. (n.d.) Accountability for Women and Child Health, 2015. Retrieved from https://www.who.int/life-course/partners/global-strategy/accountability-report-2015-no-isbn.pdf
• World Health Organization. (2018). Nurturing care for early childhood development. A Framework for helping children survive and thrive to transform health and human potential (ISBN 978-92-4-151406-4). Retrieved from https://apps.who.int/iris/bitstream/handle/10665/272603/9789241514064-eng.pdf

Acceptable (culturally safe)
“The obligation to design and implement all health-related facilities, goods and services in a way that takes full account of and is respectful of medical ethics as well as children’s needs, expectations, cultures, views and languages, paying special attention to certain groups, where necessary.”

Cultural safety is met through actions which recognise, respect, and nurture the unique cultural identity of a patient. Effective practice for a person from another culture is determined by that person or family. Culture includes, but is not restricted to, age or generation; gender; sexual orientation; occupation and socioeconomic status; ethnic origin or migrant experience; religious or spiritual beliefs; and/or ability. Unsafe cultural practice comprises any action which diminishes, demeans or disempowers the cultural identity and wellbeing of an individual (UN Committee on the Rights of the Child, 2013). (GC15)

Access to health services
Children’s right to health is defined in article 24 as an inclusive right, extending not only to timely and appropriate prevention, health promotion, curative, rehabilitative and palliative services, but also to a right to grow and develop to their full potential and live in conditions that enable them to attain the highest standard of health through the implementation of programmes that address the underlying determinants of health.

Health and other relevant services are available and accessible to all children, with special attention to under-served areas and populations. It requires a comprehensive primary healthcare system, an adequate legal framework and sustained attention to the underlying determinants of children’s health.

In this context access to health is defined as the removal of all barriers to children’s access to health services, including financial, institutional and cultural barriers. It also includes access to health education to ensure that all segments of society, in particular parents and children, are informed and are supported in the use of basic knowledge of child health and nutrition.

Accountability mechanism
Accountability refers to the obligation on the part of public officials to report on the use of public resources and answerability for failing to meet stated performance objectives.

States and other duty-bearers are accountable and must act within the rule of law. They are answerable for the observance of human rights. They have to comply with the legal norms and standards enshrined in human rights instruments. Where they fail to do so, aggrieved rights holders are entitled to institute proceedings.

Adolescent
Adolescence is a period characterized by rapid physical, cognitive and social changes, including sexual and reproductive maturation; the gradual building up of the capacity to assume adult behaviours and roles involving new responsibilities requiring new knowledge and skills. This dynamic transition period to adulthood can present specific vulnerabilities and needs (UNICEF, 2019). The World Health Organization defines individuals between the ages of 10 and 19 years as adolescents, however for the purpose of the CRC, we consider the period ends before the child reaches 19 years of age, and is therefore defined as children between the aged of 10-18 years for the GlobalChild indicators.

Antenatal care
Antenatal care (ANC) can be defined as the care provided by skilled health-care professionals to pregnant women and adolescent girls in order to ensure the best health conditions for both mother and baby during pregnancy. The components of ANC include: risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion (WHO, 2016).

Morbidity
Refers to having a disease or a symptom of disease, or to the amount of disease within a population. Morbidity also refers to medical problems caused by a treatment (National Cancer Institute, n.d.).

Post-natal care
The days and weeks following childbirth – the postnatal period – is a critical phase in the lives of mothers and newborn babies. Major changes occur during this period which determine the well-being of mothers and newborns. Yet, this is the most neglected time for the provision of quality services. Lack of appropriate care during this period could result in significant ill health and even death. Rates of provision of skilled care are lower after childbirth when compared to rates before and during childbirth. Most maternal and infant deaths occur during this time. (Care during the first 6–8 weeks after birth) (WHO, 2010;2013).